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General NPI Number Information
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NPI Number | 1366703217
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Entity Type | Organization
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Legal Business Name | VITAL MEDICAL SUPPLIES INC.
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Dates
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Enumeration Date | 06/06/2012
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Last Update Date | 04/15/2013
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Provider Practice Location Address
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Address Line | 15340 JOG ROAD SUITE 100
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City | DELRAY BEACH
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State | FLORIDA
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Zip | 33486
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Country | UM
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Telephone | 561-865-2382
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Fax | 888-519-4236
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Provider Business Mailing Address
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Address Line | 15340 JOG RD SUITE 100
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City | DELRAY BEACH
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State | FL
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Zip | 33446-2170
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Country | US
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Telephone | 561-865-2382
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Fax | 888-519-4236
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Authorized Official
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Title or Position | CEO, OFFICIAL
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Name | MR. DANIEL BENSON
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Credential |
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Telephone | 561-865-2382
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number |
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License Number State |
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